Giving Hillary Credit for SCHIP

Summary

One of Clinton’s signature claims has come under fire from political foes, quoted by the Boston Globe, who say she doesn’t deserve credit for expanding federal health insurance for millions of children.

We review the record and conclude that she deserves plenty of credit, both for the passage of the SCHIP legislation and for pushing outreach efforts to translate the law into reality.

Analysis

Hillary Clinton has made the claim literally thousands of times, repeating it constantly in her ads, debate appearances and stump speeches. She "got health insurance for six million kids," according to one ad. (The version shown here ran in Texas, but a similar ad also ran heavily in Wisconsin.)

[TET ]

Clinton Ad: "Obligation"Clinton

Narrator: She fought for universal health care long before it was popular. Got health insurance for six million kids, and expanded access to health care to the National Guard. Now she’s the only candidate for president with a plan to provide health care for every American. A top economist calls Hillary’s plan the difference between achieving universal health coverage – and falling far short. If you believe health care is America’s moral obligation, join her, Tuesday. Hillary Clinton. Clinton: I’m Hillary Clinton and I approve this message. [/TET]

What the Globe Said

We had not previously had reason to question her role in the creation of the State Children’s Health Insurance Program (SCHIP) during her husband’s administration, but last week the Boston Globe ran a story with the headline, "Clinton role in health programs disputed."

The Globe said Clinton "had little to do with crafting the landmark legislation or ushering it through Congress, according to several lawmakers, staffers, and healthcare advocates involved in the issue."

This was quickly picked up and amplified in various political blogs accusing her of exaggeration and even "lying."

So, we’ve reviewed the Globe story, and the record. The newspaper account quotes a political foe, Republican Sen. Orrin Hatch of Utah, as saying she doesn’t deserve credit for the legislation. Hatch cosponsored the legislation and has endorsed the GOP’s presumptive nominee, John McCain. The newspaper also said that "privately, some lawmakers and staff members are fuming" over Clinton’s claim but didn’t name any of them. Sen. Edward M. Kennedy, who cosponsored the 1997 legislation that eventually led to the creation of SCHIP, was asked whether Clinton was exaggerating her role. The Globe said he wouldn’t criticize Clinton "directly" but said: "Facts are stubborn things … I think we ought to stay with the facts."

What the Record Shows

Kennedy, of course, is now backing Clinton’s rival, Barack Obama, for the nomination. But last year, before that endorsement, he was quoted by the Associated Press as saying something quite different, which the Globe did not note in its story:

Sen. Edward M. Kennedy, Oct. 6, 2007: The children’s health program wouldn’t be in existence today if we didn’t have Hillary pushing for it from the other end of Pennsylvania Avenue.

In that same story, The AP’s Beth Fouhy concluded, "While Kennedy is widely viewed as the driving force behind the program, by all accounts the former first lady’s pressure was crucial." She quoted Nick Littlefield, who had been a senior health adviser to Kennedy, as saying, "we relied on her, worked with her and she was pivotal in encouraging the White House to do it."

The AP’s assessment is backed up by others we consulted. Adam Clymer, former chief Washington correspondent for the New York Times, covered the legislative maneuvering and also wrote about it in a 1999 book, "Edward M. Kennedy: A Biography." Clymer wrote that Kennedy "worked with" Hillary Clinton to get White House support for a Senate measure to grant $24 billion for the new program, rather than the $16 billion approved by the House. "With strong administration support, the $24 billion stayed in," he wrote. Then, when the bill finally passed, Kennedy "credited the President, the First Lady, [Senate Democratic Leader Tom] Daschle, Marian Wright Edelman, head of the Children’s Defense Fun, and Hatch. …"

Clymer, in an exchange of e-mails, told FactCheck.org:

Adam Clymer: On balance, I would say of course Kennedy and Hatch deserve most of the credit, but Hillary helped by making sure the Administration stuck with the $24 billion in [the Senate-House] conference. She didn’t write the legislation but she played a significant role in getting it passed.

Other accounts at the time the legislation was passed and since give Clinton substantial credit. The pro-Republican Washington Times newspaper credited (or perhaps more accurately, blamed) Hillary Clinton for the program in a 1997 article. The paper said it had obtained documents from 1993 showing that the White House "plotted" to push a "Kids First" insurance program if Mrs. Clinton’s universal health care proposal failed.

Washington Times, Aug. 6, 1997: The plan signed into law yesterday by Mr. Clinton and pushed by the first lady is a duplicate of the 4-year-old health care task force idea, except that it is paid for by a 15-cent tax on cigarettes. One of the co-authors of the plan, Sen. Edward M. Kennedy, Massachusetts Democrat, credited Mrs. Clinton for her "invaluable help, both in the fashioning and the shaping of the program."

Years later, when Clinton was first running for the Senate, Kennedy’s aide Littlefield was still giving her credit. The New York Times quoted him as saying, ”She was a one-woman army inside the White House to get this done.” He said that when President Clinton himself was showing reluctance to back the new legislation out of fear it would upset a budget deal with Republicans, "We went to Mrs. Clinton and said, ‘You’ve got to get the president to come around on this thing,’ " and she did.

More Than Just Legislating

Moreover, Hillary Clinton took a major role in translating the new law into action. The program leaves to the states the job of setting up coverage and getting children enrolled, a task that continues to be a struggle to this day. In February 1999, after 47 states had set up SCHIP programs, the Clintons launched a drive to "Insure Kids Now." Hillary took the lead, speaking first before her husband in an East Room event at the White House.

Hillary Clinton, Feb. 23, 1999: At least half of all uninsured children are eligible for federal-state health insurance programs, but too often their parents don’t know or don’t believe they qualify. As successful, for example, as Medicaid has been, an estimated 4 million eligible children are still not enrolled.

In April that year the first lady gave a speech saying nearly 1 million children had been enrolled during the previous year, but that increasing the figure was "one of the highest priorities" of her husband’s administration. She said the president would seek $1 billion to fund a five-year "outreach" effort, with a goal of increasing enrollment to 5 million by 2000. Our conclusion: Clinton is right on this one.